Association of HIV infection and antiretroviral therapy with the occurrence of an unfavorable TB treatment outcome in a rural district hospital in Eastern Cape, South Africa: A retrospective cohort study.

Autor: van de Water BJ; Connell School of Nursing, Boston College, Chestnut Hill, MA, United States of America., Fulcher I; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States of America., Cilliers S; Zithulele District Hospital, Mqanduli, Eastern Cape, South Africa., Meyer N; Zithulele District Hospital, Mqanduli, Eastern Cape, South Africa., Wilson M; Advance Access & Delivery, Durban, Kwa-Zulu Natal, South Africa., Young C; Jabulani Rural Health Foundation, Mqanduli, Eastern Cape, South Africa., Gaunt B; Zithulele District Hospital, Mqanduli, Eastern Cape, South Africa.; Family Medicine Department, Walter Sisulu University, Mthatha, Eastern Cape, South Africa., le Roux K; Zithulele District Hospital, Mqanduli, Eastern Cape, South Africa.; Family Medicine Department, Walter Sisulu University, Mthatha, Eastern Cape, South Africa.; Primary Health Care Directorate, University of Cape Town, Cape Town, Western Cape, South Africa.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 Apr 05; Vol. 17 (4), pp. e0266082. Date of Electronic Publication: 2022 Apr 05 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0266082
Abstrakt: Background: Our objective was to assess differences in TB treatment outcomes between individuals who were HIV negative, HIV positive on anti-retroviral treatment (ART) and HIV positive not on ART, at TB treatment initiation at a rural district hospital in Eastern Cape, South Africa.
Methods: This was a retrospective cohort study of individuals diagnosed with TB between January 2017 and April 2020 at a district hospital. Adults 15 years and over with reported HIV status and treatment outcome were included (N = 711). A categorical outcome with three levels was considered: unfavorable, down referral, and success. We report descriptive statistics for the association between HIV and ART status and treatment outcome using Chi-square and Fisher's exact tests. A multinomial baseline logit model was used to estimate odds ratios for treatment outcomes.
Results: Overall, 59% of included patients were HIV positive with 75% on ART. Eighty-eight patients 12% had an unfavorable outcome. Half of all patients were down referred with an additional 37% having a successful outcome. Individuals without HIV were more likely to be down referred (versus unfavorable) compared to individuals with untreated HIV (2.90 OR, 1.36, 6.17 95% CI). There was a greater likelihood for individuals without HIV having a successful TB treatment outcome compared to individuals with untreated HIV (4.98 OR, 2.07, 11.25 95% CI).
Conclusion: The majority of individuals had positive TB treatment outcomes (down referred or success). However, people without HIV had nearly five times greater odds of having successful outcomes than those with untreated HIV.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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